Becker's Hospital Review

Narrowing the Gap Makes a Difference – For Everyone Randy Pilgrim, MD, FACEP, FAAFP, Enterprise Chief Medical Officer, SCP Health The Emergency Department sits at the nexus of the outpatient world and hospital-based care. It continues to serve as a "front door" for hospitals, but also has a unique vantage point that provides insights into the community and its health care system. From this vantage point, data clearly shows an unaddressed "Care Gap" that is costing us dearly. This Gap starts when a patient leaves the emergency department and ends when they get better or fully engage in meaningful follow-up care (primary care, an appropriate specialist, or an outpatient facility). In our current system, this Gap produces worse outcomes for patients despite higher costs, creates suboptimal performance in value-based plans, and risks loss of market share for hospitals. Patients, clinicians, payors, and health systems all benefit from effective interventions that address this Gap. 1. Patients In the Gap, patients are still trying to get better, fill prescriptions, adhere to a new care plan, schedule timely appointments, and even find a doctor who will see them. With proper support in the Gap, patients get answers for their questions, strengthen primary care relationships, and receive the follow-up care they need. Data reveals that basic navigational support solves a surprising number of issues in the Gap. Low-acuity clinical visits (like telemedicine) address a majority of the rest. 2. Clinicians Without Care in the Gap, emergency departments experience increased demand and stress from patients who returned because they had no viable alternative. Clinicians encounter unsolvable situations, again responsible for patients who are not better and are now more frustrated. With support in the Gap, clinicians can trust that follow-up plans will be well-executed as directed, turning their energies to higher-value clinical work. 3. Hospitals and Health Systems Repeat visits and decreased patient satisfaction comes at a high cost to hospitals and health systems. Without Care in the Gap, patients flounder in complex post-acute systems, resulting in readmissions and higher mortality rates. With timely interventions, health systems can retain and gain market share, increase patient satisfaction, foster better outcomes, and perform better in value- based models. 4. Payors A lack of networks and effective care coordination contributes to more overall cost and avoidable utilization (ED visits and hospitalizations). In contrast, solutions in the Gap lead to increased member satisfaction, decreased costs, and a competitive advantage - all from empowering clinicians to help patients in the Gap. What happens in the Gap is critically important. For the sake of patients, clinicians, employers, and payors, and for the overall health of our system, we must be agents of transformation, invest in the continuum of our patients' journey, advocate for change, and meaningfully incorporate the emergency department as a critical element of solution- making. Anything less simply produces what we have now. It's time to make a difference. Scan the QR code in the ad to learn more about strategies for addressing the Care Gap and additional ideas to transform emergency medicine programs. Discover What Together Can Do Clinical Staffing & Workforce Optimization Care Delivery Documentation & Revenue Cycle Virtual Health Advanced Care in the Home SCP Health is where healing meets performance. Our solutions balance the unique needs of health care organizations to propel clinical and operational progress. SCAN TO READ The Gap: Why We Should Care

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